Man gains plastic ears after losing his own

Saturday

Nov 27, 2010 at 3:15 AM

TERRY RINDFLEISCH,La Crosse Tribune

LA CROSSE, Wis. (AP) — Just for fun, Allen Birchler occasionally likes to take off an ear and show it to others. "The reaction," Birchler said, "is utter surprise." The 84-year-old retired University of Wisconsin-La Crosse history professor has a pair of plastic ears.

Multiple skin cancer lesions and repeated radiation treatments over 40 years left doctors with no choice but to cut off both ears in separate operations in 2002.

"With all the radiation and whittling away at the ears so many times, we thought he would be better without them," said Dr. Brian Sieck, a Gundersen Lutheran head and neck surgeon.

Birchler's last ear was removed on Dec. 30, 2002. He and wife Margaret hosted a New Year's Eve party at their home the next night.

"I never thought about my ears as we toasted the new year," Birchler said. "I had two (ear canal) openings. I couldn't see them. It didn't bother me, my family or my friends."

But it did bother his surgeon.

"I never forgot his ears. ... People should look at Allen's eyes first when talking to him, rather than looking at his ears," Sieck said.

"But Allen then wasn't interested in a cosmetic procedure."

Sieck had left the upper part of the ear cartilage to give Birchler something to rest his glasses on, but over time he had trouble keeping them on.

But the main problem was hearing loss, which had been mild but became more significant.

"The ears are designed like a cone to focus sound for you," Sieck said.

Birchler tried regular hearing aids, but they wouldn't stay in the ear canal and he had no ear to support them.

"I finally decided to get ears, for practical reasons," he said. "It definitely was not for looks, at my age."

Sieck and Dr. Les Timm, a Gundersen Lutheran prosthodontist who works with implants and prostheses, developed a plan to implant two prosthetic ears and a special Baha implantable hearing system.

But Birchler first had to receive Medicare approval to pay for the plan.

Health insurance plans often won't pay for the implants or the hearing system, Sieck said. "It is a challenge to help people like Allen."

"Dr. Sieck went to bat for me, and wrote many letters, and finally everything was approved," Birchler said.

Sieck started work on the ear implants in the fall of 2007 by screwing three titanium posts in the bone on each side of Birchler's ear openings. A seventh titanium post was inserted just above the right ear opening for the hearing system box, or sound processor.

The process was similar to dental implants, which uses titanium posts to connect the prosthetic tooth to the jaw. But Birchler's case had an additional concern.

"It took almost a year to see if the posts would adhere to the bone," Birchler said. "The bone had been radiated so much, they didn't know if the implants would take."

When they did, Timm made an ear mold to fit Birchler's head. Once he'd decided they had a good ear and a good fit, Timm worked with Birchler to match the prosthetic to his skin tone.

Birchler got his first set of prosthetic ears late last year, then a second pair three months later. Timm recently completed painting a third set that Birchler soon will take home.

"They make three pairs for everybody — one set for winter, one set for summer and then I save the other set for special occasions," Birchler said.

He also needs backup pairs because the ears do wear out, Timm said.

Or go astray — Birchler lost one ear in his garden this summer. He thinks it fell off and was carried away by moles.

"I don't wear them in the garden anymore," he said.

The ears have a gold bar Birchler simply clips on to the implanted posts.

Sieck likes to use Birchler to play a joke on medical students, asking they examine Birchler. Except for the hearing system, the students don't notice anything unusual -until Sieck pops off Birchler's right ear.

"They say, 'Wow, it looks like the real ear,' and then they find out the other ear is prosthetic, too," Sieck said.

More importantly, Birchler's hearing has improved, especially one-on-one and in small groups. The Baha system conducts sound through the bone rather than the middle ear.

The titanium implant sets up vibrations with the skull and middle ear that stimulate the nerve fibers of the inner ear for hearing.

Birchler has adjusted well to his new ears.

"I like them now that I got them," Birchler said. "I have something to hang my glasses on, and I am very happy about how they look."

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Information from: La Crosse Tribune, http://www.lacrossetribune.com

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